Clinical Research And EvidenceStudy Finding

Angiography derived fractional flow reserve noninferiority in ALL-RISE and FAST III

March 29, 2026C. Michael Gibson MD, American College of Cardiology, NEJM

ALL-RISE and FAST III are shared as noninferiority trials suggesting angiography-based physiology can match wire-based FFR for intermediate lesions, with reported procedural efficiencies like less contrast and shorter fluoroscopy time.

ALL-RISE trial: FFRangio demonstrated non-inferior 1-year MACE rate compared to conventional pressure wire-based assessment for intermediate coronary lesions, with less contrast volume and shorter fluoroscopy and procedure times.
FAST III trial: In patients with intermediate coronary lesions, vFFR-guided revascularization strategy was non-inferior to FFR-guided approach for the 1-year risk of death, MI, or unplanned revascularization.
I think its time to move away from wire based physiological assessment to much better methods available
C. Michael Gibson MD
American College of Cardiology
NEJM
trialFFRnoninferiority

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